Butterick Municipal Building STERLING BOARD OF HEALTH 1 978 422 8111 ext 2305 APPLICATION F by asc13041

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									                                 Butterick Municipal Building
                         STERLING BOARD OF HEALTH
                                  1-978-422-8111 ext. 2305



       APPLICATION FOR BEAVER CONFLICT RESOLUTION PERMIT
                               PROPERTY OWNER CONSENT FORM




I, _____________________________________________________, as owner of the property at
   Property Owner

_______________________________________________________, consent to allow
   Street Address and Assessors’ Map & Lot #

_______________________________________________________, who is under contract with
   Consultant or State Licensed Trapper Name

_______________________________________________________, to enter my property for
   Applicant’s Name

the purpose of installing water level devices and/or trapping and removing beavers that are
causing a threat to public health and safety as determined by the Sterling Board of Health. I
understand that any water level control measures or alteration of wetlands or beaver
structures will also be permitted or authorized through the Sterling Conservation Commission.




__________________________________________________                 _____________________
   Signature                                                               Date

								
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